Vitamin C improves healing of foot ulcers: a randomised, double-blind, placebo-controlled trial. Issue 10 (28th November 2021)

• Record Type: Journal Article
• Authors: Gunton, Jenny E.; Girgis, Christian M.; Lau, Timothea; Vicaretti, Mauro; Begg, Lindy; Flood, Victoria
• Is Part Of: British journal of nutrition. Volume 126:Issue 10(2021)
• Page Start: 1451
• Page End: 1458
• Publication Date: 2021-11-28
• Subjects: Foot ulcer -- Vitamin C -- Ulcer healing -- Amputation -- Diabetes -- Vascular disease; Nutrition -- Periodicals; 572.4
• DOI: 10.1017/S0007114520003815
• Languages: English
• ISSNs: 0007-1145

Abstract

Abstract: Chronic foot ulcers are associated with a high risk of osteomyelitis, poor quality of life, amputations and disability. Few strategies improve their healing, and amputation rates in high-risk foot services are usually over 30 %. We conducted a randomised, inactive-placebo controlled, double-blind trial of 500 mg of slow-release vitamin C in sixteen people with foot ulcers in the Foot Wound Clinic at Westmead Hospital. Nine were randomised to control and seven to vitamin C. When serum vitamin C results become available at 4 weeks, all people with deficiency were offered both vitamin C and glucosamine tablets for the next 4 weeks. Patients without baseline deficiency continued their original assigned treatment. The primary outcome was percentage ulcer healing (reduction in ulcer size) at 8 weeks. Fifty percentage of subjects had baseline vitamin C deficiency, half having undetectable levels. Healing at 8 weeks was significantly better in the vitamin C group (median 100 v . –14 %, P = 0·041). Healing without amputation occurred in all patients in the vitamin C group. In contrast, 44 % of controls had not healed their ulcer at the end of the study period. Vitamin C improved healing of foot ulcers. Further studies are needed to determine whether there is a threshold effect for serum vitamin C above which therapy is ineffective and whether there are better or lesser responding subgroups. Because of its low cost and ease of access and administration, we recommend offering vitamin C therapy to all people who have chronic foot ulcers and potentially suboptimal vitamin C intake. Trial registration number: ACTRN12617001142325.